Focused ultrasound (FUS) is finding increasing applications in the brain and body due to its unique ability to non-invasively activate and inhibit neurons. While this has raised hope of a non-opioid, non-addictive treatment for chronic pain, no studies have looked at FUS for pain management. To translate its use to humans, researchers are developing technologies to guide treatment and dosing.

“Ultrasound neuromodulation is an exciting area because it allows you to alter activity non-invasively, with fine spatial precision, in deep or superficial brain targets.”

“While other devices to treat pain exist, their efficacy is limited by inaccurate targeting of pain regions and circuits in the brain,” said William Grissom, Ph.D., associate professor of biomedical engineering at Vanderbilt and a principal investigator on the project. “Ultrasound neuromodulation is an exciting area because it allows you to alter activity non-invasively, with fine spatial precision, in deep or superficial brain targets.”

Targeting Specific Pain Nodes

Deep brain stimulation and ablation procedures are currently used clinically, targeting the thalamic nuclei, ACC, and PAG/PVG regions of the cortex, but there are technological challenges. The researchers hope to use FUS neuromodulation to accurately and reliably stimulate these brain regions associated with pain.

“With device-based solutions, it is challenging to know prior to implantation whether the pain node being stimulated will alleviate chronic pain symptoms,” said Charles Caskey, Ph.D., lead principal investigator on the project and assistant professor of biomedical engineering, radiology and radiological sciences at Vanderbilt. “We hope that understanding how different neuromodulatory effects at various targets affect pain will improve the efficacy of existing methods and guide the development of improved treatments.”

The device will resemble an MRI head coil and combine functional MRI with FUS neuromodulation. It will allow the researchers to navigate to precise brain regions under MRI guidance and to monitor the responses of pain circuits using a functional MRI (fMRI) readout.

Grissom hopes that the device will become a viable alternative to long-term opioid use for chronic pain. “Device-based treatments offer an alternative that may eliminate risks such as addiction and drug diversion,” he said. “By the end of the project, we expect to have a fully developed and validated an MRI-guided ultrasound system that is ready for pilot clinical trials in various pain management applications.”

Refer a Patient

Bio(s)

Charles Caskey, Ph.D., is an assistant professor of biomedical engineering, radiology and radiological sciences at Vanderbilt University Medical Center. His research is focused on the diagnostic and therapeutic uses of ultrasound, especially image-guided therapy applications where therapeutic ultrasound is guided by ultrasonic imaging or combined with another imaging modality, such as MRI.